Certified Medical Coder/Biller

La Pine Community Health Center•La Pine, OR

1d•Onsite

About The Position

NOTE: This is not a Remote position General Statement of Duties The Certified Coder is a member of the Billing Team and is responsible for insuring the accuracy and completeness of clinical coding. Also assists with claims submission and follow up, researches claim denials and follows up with insurances and patients. Communicates with patients, insurance companies, and staff to ensure the health center’s billing and collections processes are carried out in accordance with established policies. Overall responsibility is to maximize revenues and cash flow to the organization.

Requirements

Current Medical Coding Certification
Knowledge of medical insurance billing procedures, including CPT and ICD coding
Establish and maintain effective and harmonious working relationships with staff, patients, vendors, and the public
Maintain excellent oral and written communication skills and an ability to practice effective professional communication
Thrive and promote group cohesion as a team member in a rapidly changing environment
Follow detailed and written oral instructions
Multi-task and adjust priorities in a fast-paced environment, while maintaining focus and managing disruptions and/or unexpected needs
Accept feedback from a variety of sources and constructively manage any conflicts
Maintain excellent organization skills
Execute and track detail-oriented projects and deadlines
Demonstrate professionalism
Demonstrate good judgement while working independently or as part of a team
Maintain punctual attendance
Maintain general computer and keyboarding skills
Submit to and pass a drug test
Successfully complete a criminal background check
Maintain HIPAA compliance and follow confidentiality policies to protect organizational information
Foster ethical behavior, cultural sensitivity, and an inclusive environment in accordance with our Standards of Conduct and Respectful Workplace Policies
Work beyond normal working hours, including weekends, if applicable and when required

Nice To Haves

Intermediate or advanced knowledge of Microsoft Office Products: Excel, Outlook, Word, and Power Point
Knowledge of Federally Qualified Health Centers
High school graduate or GED

Responsibilities

Review codes for all documented professional services provided Applies CPT, ICD, HCPCS and modifiers following coding guidelines
New vs Established evaluation and management code selection
Missing orders for services that are documented but not coded
Age mismatch on wellness CPT codes and ICD codes
Other age or gender coding mismatch issues
Diagnosis resequencing
Removal of preventative diagnosis codes on problem focused office visits
Add or remove primary or add on lesion destruction procedure code per the documentation
Telemedicine coding changes, as required by insurance payer
Contraceptive method implant/removals coding redetermination
Provides training to providers and LCHC staff as needed
Monitoring and working all billing work queues; to include coding, researching, correcting claims and trending of coding/billing behaviors
Reviews future scheduled appointments to ensure that registration and insurances are accurate
Adheres to official coding guidelines, AMA and CMS
Keeps abreast of reimbursement reporting requirements
Fields coding questions and ensures review of patient concerns as well as insurance related inquires on behalf of providers as needed
Discusses accounts with patients as needed and provides resolution to accounts
Insurance and patient payment posting
Refund insurances and patients as appropriate
Notifies uninsured patients of anticipated charges prior to appointments
Illustrate knowledge of healthcare industry in areas of coding, revenue cycle, claims and state specific insurance/laws
Ensures timely charge review/processing of daily submissions
Assists with manual claim submission
Research claim denials and follows up appropriately
Assists with patient payments and payment plans
Ensures electronic patient accounts are accurate
Assists in maintaining health center’s fee schedule
Maintains filing system for all material related to billing and collection functions in accordance with organizational standards
Participates in staff meetings, trainings, and quality assurance activities as directed
Performs other duties as assigned